Five Common Illnesses After Enlisting—From Causes to What to Do
When I enlisted, conditions for new recruits were not exactly ideal, and there were times when trainees struggled because they were sick. Things may not be quite like that anymore, but being ill is never easy—especially when you are away from home.
Dozens of recruits sleep in the same cramped barracks, follow a fixed training schedule every day, and abide by group rules governing meals and hygiene rather than managing those things independently.
Such a dramatic change in environment can trigger unexpected warning signs from the body.
It is no coincidence that so many recruits catch a cold, develop raw feet, come down with red, bloodshot eyes, or suddenly suffer an upset stomach after arriving at boot camp.
From a medical analyst’s perspective, these conditions are largely linked to three factors specific to military life: close-quarters communal living, a sudden increase in physical activity, and limited control over hygiene.
Today, we will look at the five illnesses soldiers most commonly experience after enlisting—boot-camp colds, or acute upper respiratory infections; epidemic eye infections, or keratoconjunctivitis; athlete’s foot, or tinea pedis; march fractures, or stress fractures; and acute gastroenteritis caused by norovirus—with a focus on their causes, symptoms, and practical ways to respond.
1. Boot-Camp Colds (Acute Upper Respiratory Infections)
Causes
An upper respiratory infection is inflammation of the upper airways, including the nose, pharynx, larynx, and trachea. Commonly referred to as a cold, it is usually caused by a virus.
Bacterial infections account for fewer than 5 to 10 percent of cases. The real problem is how quickly these infections spread. In communal settings, they can easily pass from one person to another, and boot camp is a textbook example of a crowded environment, with dozens of people sleeping, eating, and training together in close quarters.
Cases often spike after exercises such as individual combat training, which involve rolling around on the ground—and summer is no exception. Transmission between trainees is considered the main reason.
Symptoms
Persistent runny or blocked-up nose can force you to breathe through your mouth, leaving your throat dry and swollen. If the tonsils become inflamed, symptoms may include a high fever, difficulty swallowing, and trouble breathing.
A fever may indicate something more serious than a mild cold, so medical attention is warranted. If inflammation of the lower airways is suspected, a chest X-ray may be needed to check for bronchitis or pneumonia.
Rarely, illnesses such as invasive meningococcal disease can begin with cold-like symptoms and then worsen rapidly. If fever or chills are accompanied by headaches and muscle aches that become markedly worse within a short period, notify the medical staff or a hospital immediately.
Treatment and Relief
Upper respiratory infections are generally treated with supportive care aimed at relieving symptoms. Antibiotics help only when a bacterial infection or complication is suspected; they do not speed recovery from an ordinary viral cold.
Plenty of fluids and rest are the foundations of recovery, while maintaining a comfortable level of indoor humidity may also ease symptoms.
Frequent handwashing and good personal hygiene are the most important preventive measures. Still, in a crowded setting such as boot camp, where the environment itself is difficult to change, it is not easy to avoid infection through personal effort alone. If symptoms worsen or persist, do not try to tough it out—tell the medical staff.
People with chronic respiratory conditions such as allergic rhinitis or asthma need to be especially careful, as what begins as a simple cold can develop into chronic bronchitis or pneumonia.
2. Epidemic Eye Infections (Epidemic Keratoconjunctivitis)
Causes
Epidemic keratoconjunctivitis is a highly contagious infection in which adenovirus causes inflammation of the conjunctiva and cornea.
Adenovirus spreads easily not only through tears and eye discharge but also through indirect contact with objects touched by an infected person.
In an environment such as boot camp, where bedding, towels, and personal belongings are kept close together and shared living is the norm, indirect transmission becomes much more likely.
There is an incubation period of about one week after infection, but people may already be contagious during that time. As a result, it is common for someone to spread the virus without realizing they are infected.
A similar condition, acute hemorrhagic conjunctivitis—often called Apollo eye disease—is caused by enterovirus 70. It is also known to occur frequently, regardless of season, in communal settings where maintaining good hygiene is difficult.
Symptoms
The condition typically begins with sudden redness in the eye, accompanied by eye pain and excessive tearing.
Other symptoms may include a gritty sensation, itching, sensitivity to light, and swollen eyelids. In most cases, the lymph nodes in front of the ears also become swollen. One eye is usually infected first, followed by the other two to seven days later.
With Apollo eye disease, subconjunctival hemorrhaging—blood pooling in the white of the eye—is highly common. This tends to make the eye look even redder than it does with epidemic keratoconjunctivitis.
Treatment and Relief
If epidemic keratoconjunctivitis is suspected, the standard advice is to see an eye specialist immediately.
Eye drops should be used only in the infected eye and must never be shared with anyone else. Apollo eye disease is usually treated with supportive care, including anti-inflammatory medication. When symptoms are severe, antiviral eye drops containing interferon may also be prescribed.
Full recovery usually takes two to three weeks. The most important preventive measure is to wash your hands thoroughly with soap for at least 30 seconds. Personal items such as towels, pillows, and eye drops should never be shared.
If you develop an eye infection, avoid touching your eyes, and take particular care not to touch other people after touching the infected eye.
At boot camp and in military units, people with eye infections are often isolated and excused from training to prevent transmission. If your eyes become red or feel gritty, reporting it immediately is the best choice for both you and your fellow recruits.
3. Athlete’s Foot (Tinea Pedis)
Causes
Athlete’s foot, or tinea pedis, is an infection caused by dermatophytes, a type of fungus.
Because these fungi thrive in warm, damp environments, the feet—especially the spaces between the toes—are particularly vulnerable.
Military boots and long hours of activity make sweaty feet common, creating ideal conditions for fungal growth.
The infection can also spread from person to person through communal showers and washrooms, floors walked on barefoot, and shared slippers or shoes.
Along with dormitories and athletic training camps, military boot camps are considered classic settings for the spread of athlete’s foot because large numbers of people live together.
Symptoms
Typical symptoms include scaly skin, redness, and itching on the feet. The most common form causes the skin between the toes to crack, peel, and turn red. Because this area is poorly ventilated and tends to stay damp, severe itching and an unpleasant foot odor are also common.
Scratching the area or treating it incorrectly can damage the skin and lead to a secondary bacterial infection, so caution is needed.
Treatment and Relief
The standard treatment is a topical antifungal applied directly to the affected area, along with keeping the feet dry.
For mild cases, applying an antifungal cream consistently for four to eight weeks can lead to a complete cure. It is best to apply it not only to the affected skin but also to the surrounding healthy skin.
Athlete’s foot is prone to recurrence, however, and stopping treatment as soon as the symptoms disappear often allows it to return later.
If topical treatment does not produce satisfactory results, oral antifungals such as itraconazole or terbinafine may be prescribed as well.
To prevent infection, wash your feet after training or daily duties, dry them thoroughly, and change your socks. Carrying extra pairs of socks and keeping your feet dry is the most practical way to prevent recurrence.
4. March Fractures (Stress Fractures)
Causes
A stress fracture is a tiny fracture or crack that develops when repeated stress or impact builds up in a bone, without a major injury such as a traffic accident.
When muscles become fatigued from prolonged use, they can no longer absorb shock effectively. The impact is then transferred to the bones, where a fracture can develop.
Because soldiers often experience them after repeated marches, stress fractures are commonly called march fractures.
People who were not very active before enlisting may suddenly face intense training and repeated marches. If their muscles cannot handle the added strain, the bones are placed under excessive stress.
Stress fractures are particularly common among athletes and military recruits. The risk is also higher for people with foot structures that absorb shock poorly, such as flat feet or high arches, and for those who walk or run on hard surfaces for long periods.
Symptoms
They most often occur in the shinbone below the knee, the area between the toes and ankle, and the heel.
At first, symptoms may be limited to stiffness in the morning or pain when taking the first steps after resting. The pain gradually worsens and may eventually make it difficult to bear weight.
Because early pain can be mild enough to be mistaken for ordinary muscle soreness, many people have already developed significant microfractures by the time they seek medical care.
A fracture line may not show up clearly on an X-ray within 10 to 14 days of the injury. If a stress fracture is suspected clinically but does not appear on an X-ray, more detailed testing such as an MRI, CT scan, or bone scan may be necessary.
Treatment and Relief
The most important step in treating a stress fracture is early detection and minimizing use of the painful area before symptoms become severe.
Depending on the condition, treatment may involve rest, a splint, or a cast. Medication and physical therapy can also be used, and pain often improves within about a month.
If treatment is delayed and the injury is not properly managed, it can progress to a complete fracture and require surgery, including bone grafting.
During recovery, low-impact activities such as walking in water, swimming, or using a stationary bike at low intensity can help maintain muscle strength and prevent recurrence.
Above all, if pain while walking or running lasts for more than one or two weeks, or if swelling and discomfort continue, it is much safer in the long run to seek an accurate diagnosis from the medical staff or an orthopedic specialist rather than continuing to train through the pain.
5. Acute Gastroenteritis Caused by Norovirus
Causes
Norovirus gastroenteritis is a highly contagious viral infection and one of the leading causes of nonbacterial gastroenteritis in crowded settings such as nursing homes, camps, military bases, and communities.
It spreads through contaminated food or water and through the fecal-oral route, including direct contact with an infected person. Infection can also occur when someone touches an object such as a doorknob after an infected person has handled it without washing their hands, then touches their mouth or eats food.
Shared dining facilities, where many people eat the same food, along with communal bathrooms and wash areas, create ideal conditions for rapid transmission within a military unit.
The fact that people are most contagious two to five days after symptoms begin also contributes to outbreaks.
Symptoms
After an average incubation period of 24 to 48 hours, symptoms such as sudden vomiting, nausea, retching, and diarrhea appear. They generally last 48 to 72 hours, after which most people recover quickly.
Diarrhea is more common in adults, and systemic symptoms such as headaches, fever, chills, and muscle aches often occur as well.
Watery diarrhea may occur several times a day. Unlike some bacterial forms of gastroenteritis, however, norovirus does not typically cause inflammation of the small intestine, so the diarrhea is generally not bloody or mucous-filled.
Treatment and Relief
There is no specific antiviral drug or vaccine for norovirus, and most people recover within a few days without special treatment.
The most important priority is preventing dehydration. Even if you are vomiting, try to take small sips of water frequently, as much as you can tolerate.
If diarrhea lasts longer than 24 to 48 hours and there is no blood in the stool, an antidiarrheal may be used. However, it is safer not to take one without medical advice if fever and diarrhea occur together or bloody stool is suspected. Severe dehydration or an electrolyte imbalance may require intravenous fluids.
Washing your hands thoroughly with soap and running water is the most effective preventive measure. Be especially diligent about washing your hands before meals and after using the bathroom. Anyone with symptoms should be excused from food preparation or serving duties, and using separate utensils and towels can also help prevent the infection from spreading.
Five Conditions, One Common Story
Boot-camp colds, epidemic eye infections, athlete’s foot, march fractures, and norovirus gastroenteritis all ultimately arise from the same underlying conditions: large numbers of people living in close quarters, a sudden increase in physical activity, and an environment in which individuals have limited control over their own hygiene.
These five conditions can be difficult to avoid completely, no matter how careful you are. But basic habits such as washing your hands and caring for your feet, combined with reporting pain or other symptoms early instead of ignoring them, can prevent many cases or keep them from getting worse.
When your body sends a warning signal, do not dismiss it by thinking, “Everyone goes through this.” Reporting symptoms early to the medical staff or a hospital is the most practical way to protect not only your own health but also that of the people living and training alongside you.
Frequently Asked Questions (FAQ)
Q1. Why do boot-camp colds seem to take so long to go away?
Boot-camp colds often seem to linger because recruits may become reinfected by someone else before they have fully recovered. As long as everyone continues living together in cramped barracks, it is difficult to break the chain of infection through individual recovery alone. Fortunately, once conditions become more stable during later-stage training or after assignment to a permanent unit, symptoms often improve within a month. There is no need to worry excessively, but anyone with a high fever or long-lasting symptoms should seek medical attention.
Q2. If I have an eye infection, can I continue training?
Epidemic keratoconjunctivitis and Apollo eye disease are highly contagious. If you have symptoms, do not decide on your own whether to attend training—notify the medical staff first. In many units, people are isolated and excused from training for a period of time to prevent transmission. Reporting an eye infection early is the best option, since ignoring it puts not only your own eye health at risk but also the health of everyone around you.
Q3. Is athlete’s foot impossible to cure?
With consistent treatment and care, it can be cured. However, recurrence is very common when people stop applying antifungal cream after only a few days because the itching has improved. Even if the infection appears to be gone, continuing treatment for at least four to eight weeks is key to preventing recurrence. Keeping your feet dry is equally important.
Q4. How can I tell whether leg pain after a march is ordinary muscle soreness or a stress fracture?
Ordinary muscle soreness tends to gradually improve after a few days of rest. A stress fracture, by contrast, does not improve with time and may become more painful every time you walk. Pain is often particularly noticeable when taking the first steps in the morning. If pain lasts for more than one or two weeks or is accompanied by swelling, do not dismiss it as muscle soreness. Seek an accurate diagnosis from the medical staff or an orthopedic specialist.
Q5. How long will I be unable to train if I get norovirus gastroenteritis?
In most cases, symptoms improve within 48 to 72 hours without special treatment. However, the virus may continue to be shed in the stool for some time after recovery. Even once symptoms have completely disappeared, avoiding food preparation or serving duties for several days and paying extra attention to personal hygiene are important ways to avoid infecting others. If dehydration is severe or symptoms last more than a week, medical evaluation is essential.
